Nitric oxide therapy in COVID-19 patients with acute respiratory distress in intensive care unit

Abstract

Objective: Administration of inhaled nitric oxide (iNO) is a promising, new, non-standard approach to directly treat viral load while increasing oxygenation. The aim of this research was to elucidate the clinical and laboratory response to the treatment of the patients who were diagnosed with COVID-19 in the intensive care unit (İCU) and followed-up due to respiratory failure and given iNO. Materials & Method: A total of 46 individuals who were diagnosed with COVID-19 and developed severe respiratory failure, were followed up with or without intubation, had previously received anti-cytokine therapy, and tried prone position were evaluated within the scope of the study. The time to start iNO treatment in the İCU, if iNO was applied after RT-PCR positivity, whether iNO was given with or without intubation were obtained from hospital records. Results: A statistically significant difference has been achieved in arterial partial pressure of oxygen (PaO2), peripheral oxygen saturation (SpO2) and ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO2/FİO2) ratios before and after iNO (p<0.05). There were increases after iNO initiation compared to before iNO in all laboratory parameters with significant differences. It was determined that the iNO onset times of deceased patients were significantly delayed. The relationship between the duration of mechanical ventilation, the duration of stay in the İCU, and the onset of iNO was statistically significant relationship between all measurements (p<0.05). Conclusion: iNO has been suggested as an alternative rescue methodbefore invasive treatment, especially for the relief of hypoxemia. However, the effective dose and safety of iNO is still not clear.